Category: Nevin Manimala

J Robot Surg. 2025 Sep 4;19(1):557. doi: 10.1007/s11701-025-02727-1.

ABSTRACT

The objective of this study is to analyze national trends in the adoption of robotic-assisted thoracoscopic surgery (RATS) for lung cancer resections compared to video-assisted thoracoscopic surgery (VATS) and open approaches across geographic regions and institution types in the National Cancer Database (NCDB). A retrospective cohort study was performed of adults who underwent a lung resection for non-small cell lung cancer between 2010 and 2021 in the NCDB. Data were stratified by facility type, surrounding area population, and geographic location. Multivariable logistic regressions with interaction terms were used to determine if the change in rates of RATS varied by facility type, surrounding population, and location. A total of 301,123 oncologic lung resections were included in this study. The total number of RATS surpassed VATS in 2019, with 9579 and 9454 cases, respectively. By 2021, RATS accounted for 65.4% of minimally invasive cases. Academic programs were found to be increasing the proportion of their RATS resections at a faster rate than community programs. Facilities in metropolitan settings are adopting robotic resections at a more rapid rate than in urban and rural areas. The rate of RATS adoption varied significantly by region, with the East South-Central region having the slowest adoption rate. In contrast, the South Atlantic and East North-Central regions experienced the highest rate of increase in RATS adoption. RATS for oncologic lung resection is increasing and has surpassed VATS and open resections as of 2019. RATS resections are growing most rapidly in academic and metropolitan programs, and in certain geographic regions.

PMID:40908399 | DOI:10.1007/s11701-025-02727-1

Endocrine. 2025 Sep 4. doi: 10.1007/s12020-025-04412-7. Online ahead of print.

ABSTRACT

BACKGROUND: Depression is a common but often underrecognized comorbidity in individuals with diabetes mellitus. Identifying its prevalence can help in early intervention and better management.

OBJECTIVE: To estimate the proportion of depression in patients with diabetes mellitus using the Hamilton Depression Rating Scale (HAM-D) and to evaluate associations with gender, age, diabetes duration, and comorbid conditions.

METHODS: This descriptive cross-sectional study was conducted among 89 diabetic patients attending outpatient services at a tertiary care hospital. Data was collected via structured interviews using the HAM-D [1] questionnaire. A HAM-D score ≥ 8 was considered indicative of depression. Data analysis was conducted using descriptive statistics and subgroup analysis based on gender, age groups, and other variables.

RESULTS: Among 89 patients, 26 (29.2%) were found to have depression. The prevalence was higher in females (36.8%) compared to males (23.5%). Depression was more frequent in older age groups, particularly among patients aged 60-74 years. [Pie chart and bar graphs to be inserted.] CONCLUSION: A significant proportion of diabetic patients exhibit depressive symptoms, particularly older individuals and females. Routine screening using tools like HAM-D can aid in early identification and intervention.

PMID:40908393 | DOI:10.1007/s12020-025-04412-7

J Robot Surg. 2025 Sep 5;19(1):558. doi: 10.1007/s11701-025-02657-y.

ABSTRACT

This comprehensive systematic review assesses the clinical outcomes of robotic-assisted procedures for acute abdominal emergencies, analyzing data from 27 studies comprising 1142 cases. The investigation specifically examines five critical emergency conditions: complicated appendicitis (representing 32.5% of cases), acute cholecystitis (28.7%), small bowel obstruction (15.2%), perforated peptic ulcers (9.8%), and acute diverticulitis (7.4%). Analysis reveals robotic procedures averaged 152 min (± 38) in duration, with an overall conversion rate of 9.1%. Complication rates showed no significant difference from laparoscopic methods (13.2% versus 14.7%, p = 0.21). The data highlight two significant robotic advantages: improved intraoperative hemostasis (85 mL versus 120 mL average blood loss, p = 0.03) and lower conversion rates among obese patients (11.3% versus 18.6%, p = 0.04). These findings indicate that robotic systems may provide distinct technical benefits for specific emergency scenarios while delivering safety outcomes equivalent to traditional minimally invasive surgery.

PMID:40908371 | DOI:10.1007/s11701-025-02657-y

Bull Environ Contam Toxicol. 2025 Sep 4;115(3):37. doi: 10.1007/s00128-025-04101-1.

ABSTRACT

This study aimed to assess the environmental and health risks of heavy metal contamination from e-waste recycling in Lahore, Pakistan. Surface soil (0-15 cm) samples were collected from recycling facilities, and heavy metal concentrations were measured using atomic absorption spectrophotometry. The mean concentrations (mg/kg) of Cadmium (Cd) (5.38), Copper (Cu) (835.53), Lead (Pb) (468.90), Mercury (Hg) (1.61), and Zinc (Zn) (416.39) exceeded European Union (EU) guidelines, while Manganese (Mn) (372.29), Iron (Fe) (750.05), Arsenic (As) (6.96) and Chromium (Cr) (64.80) were within limits. Soil contamination indices indicated soil quality deterioration. The highest ecological risks (Er) were from Cd (1646.232) and Hg (322.15). Children faced higher non-carcinogenic risk (2.93) and carcinogenic risk (1.76 × 10⁻³), particularly from Pb (1.74) and Cu (1.56 × 10⁻³), respectively, while adults faced no significant risks. These findings highlight the need for sustainable e-waste management practices in Pakistan.

PMID:40908348 | DOI:10.1007/s00128-025-04101-1

Eur J Orthop Surg Traumatol. 2025 Sep 4;35(1):380. doi: 10.1007/s00590-025-04504-0.

ABSTRACT

PURPOSE: To evaluate the effect of intraoperative tranexamic acid (TXA) on perioperative blood loss, transfusion requirements, and clinical outcomes in patients undergoing proximal femoral nailing (PFN) for intertrochanteric fractures.

METHODS: A retrospective cohort study of 1,728 patients who underwent PFN fixation for intertrochanteric fractures between 2017 and 2024. Perioperative hemoglobin (Hb) dynamics, transfusion requirements, and clinical outcomes were compared between patients receiving 1-1.5 g intravenous TXA (n = 1,446) and controls (n = 282).

RESULTS: The TXA group demonstrated reduced perioperative Hb decline (2.15 ± 1.40 vs 2.76 ± 1.57 g/dL, p < 0.001) and lower rates of Hb drop > 2 g/dL (47.9% vs 63.5%, OR 0.53, p < 0.001). TXA administration was associated with decreased transfusion requirements (7.1% vs 11.0%, p = 0.021). Multivariate analysis confirmed TXA as an independent protective factor against blood loss. Mortality rates showed no significant difference between groups.

CONCLUSION: Intraoperative TXA during PFN fixation was associated with reduced perioperative blood loss and transfusion requirements. These findings support TXA as an effective blood conservation strategy in elderly patients with intertrochanteric fractures.

PMID:40908344 | DOI:10.1007/s00590-025-04504-0

J Thromb Thrombolysis. 2025 Sep 4. doi: 10.1007/s11239-025-03178-z. Online ahead of print.

ABSTRACT

Optimal systolic blood pressure (SBP) targets after endovascular therapy (EVT) for stroke in older adults (≥ 65 years) remain undefined. This study assessed age-stratified associations between early post-EVT SBP (first 6 h) and outcomes. Post hoc analysis of two trials. Patients were stratified by age (18-64 vs. ≥ 65 years) and SBP (≤ 120, 120-140, > 140 mmHg). Primary outcome was 90-day functional status (modified Rankin Scale, mRS). Inverse probability treatment weighting (IPTW) and multivariable regression adjusted for confounders. Post-EVT SBP data were available for 267 young and 395 old patients. IPTW analysis revealed that sustained SBP below 120 mmHg during the first 6 h post-EVT significantly enhanced functional independence in elderly patients (common OR: 2.00; 95% CI: 1.18-3.39). Among young cohorts, maintenance of SBP ≤ 120 mmHg (cOR, 2.89; 95% CI, 1.45-5.82) and 120-140 mmHg (cOR, 3.18; 95% CI, 1.58-6.47) were associated with a better outcome. sICH incidence demonstrated no statistically significant association with systolic blood pressure (SBP) levels (P = 0.21; 95% CI: 0.93-1.35). During the initial 6-h window post-EVT, younger patients with SBP ≤ 140 mmHg and elderly patients with SBP ≤ 120 mmHg were associated with favorable outcome. These results suggest that stricter blood pressure control may be particularly beneficial for older adults in the early post-EVT phase.Trial Registration: The DEVT registration: URL: http://www.chictr.org.cn ; Chinese Clinical Trial Registry: ChiCTR-IOR-17013568, and the RESCUE BT registration: URL: http://www.chictr.org.cn ; ChiCTR-INR-17014167.

PMID:40908335 | DOI:10.1007/s11239-025-03178-z

Surg Endosc. 2025 Sep 4. doi: 10.1007/s00464-025-12162-w. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of laparoscopy combined with intraoperative choledochoscopy in treating choledochal cysts and preventing postoperative complications.

PATIENTS AND METHODS: This single-center retrospective study included 208 patients with Todani type I choledochal cysts treated laparoscopically from January 2016 to January 2023. Patients undergoing open surgery were excluded. Of these, 138 cases were treated with 6 Fr catheter irrigation (Group A), while 70 cases underwent intraoperative choledochoscopy for thorough irrigation and stone extraction (Group B). All patients were followed up for at least 18 months. Data collected included age at operation, gender, cyst diameter, preoperative manifestations, and postoperative outcomes. Statistical analysis was performed using Student’s t-test for continuous data and Fisher’s exact test for categorical data, with P < 0.05 indicating significance.

RESULTS: Clinical data of 187 cases were analyzed after excluding 21 lost to follow-up. No significant differences were found between Group A (n = 124) and Group B (n = 63) in age at operation (35.4 ± 17.2 months vs. 38.9 ± 19.6 months, P = 0.875), gender distribution (male:female ratio 34:90 vs. 13:50, P = 0.891), cyst diameter (25.6 ± 17.8 mm vs. 23.1 ± 17.5 mm, P = 0.758), or preoperative stone presence (54/124 vs. 25/63, P = 0.918). However, Group B had significantly lower incidence of residual/recurrent stones (1/63 vs. 14/124, P = 0.021) and postoperative pancreatitis (1/63 vs. 7/124, P = 0.044). At 6-month follow-up, intrahepatic bile duct dilation was significantly lower in Group B (0/63 vs. 6/124, P = 0.038), and hospital stay was shorter (9.1 ± 2.2 days vs. 10.7 ± 2.1 days, P = 0.003) without significant increase in total medical expenses (39059.6 ± 4115.3 RMB vs. 38422.8 ± 3341.6 RMB, P = 0.291).

CONCLUSIONS: Laparoscopy combined with intraoperative choledochoscopy is feasible and effective in clearing biliary stones, preventing postoperative complications such as pancreatitis and bile duct dilation, and identifying hepatic duct stenosis in choledochal cyst treatment.

PMID:40908333 | DOI:10.1007/s00464-025-12162-w

Behav Res Methods. 2025 Sep 4;57(10):275. doi: 10.3758/s13428-025-02772-6.

ABSTRACT

Computational models of early language development involve implementing theories of learning as functional learning algorithms, exposing these models to realistic language input, and comparing learning outcomes to those in infants. While recent research has made major strides in developing more powerful learning models and evaluation protocols grounded in infant data, models are still predominantly trained with non-naturalistic input data, such as crowd-sourced read speech or text transcripts. This is due to the lack of suitable child-directed speech (CDS) corpora in terms of scale and quality. In parallel, the question of how properties and individual variability in language input affect learning outcomes is an active area of empirical research, underlining the need for realistic yet controllable data for modeling such phenomena. This paper presents a solution to the training data problem through stochastic generation of naturalistic CDS data using statistical models, thereby enabling controlled computational simulations with naturalistic input. We provide a proof-of-concept demonstration of the approach by showing how naturalistic CDS transcripts can be generated with a language model conditioned on recipient information (here, infant age), and how text-to-speech systems can be used to convert the transcripts to high-quality speech with a controllable speaking style. We also conduct modeling experiments with generated speech corpora by varying different aspects of the data, showing how this maps into different learning outcomes, thereby demonstrating the feasibility of the approach for controlled language learning simulations. Finally, we discuss the limitations of using synthetic data in general, and of the present proof-of-concept pipeline in particular.

PMID:40908330 | DOI:10.3758/s13428-025-02772-6

J Cancer Res Clin Oncol. 2025 Sep 5;151(9):242. doi: 10.1007/s00432-025-06281-z.

ABSTRACT

AIM: Early cervical cancer diagnosis is a global challenge that needs to be addressed by the discovery of less invasive diagnostic and prognostic approaches. Circulating miRNAs are stable in plasma and their diagnostic potentials have been elucidated in some cancers. Therefore, in this cross-sectional study, we determined the patterns of expression of 7 selected circulating microRNAs that differ between patients with cervical cancer receiving therapy, patients with cervical not on therapy and healthy females. The goal was to investigate the diagnostic and prognostic potential of these selected miRNAs.

METHODS: Total RNA was extracted from plasma samples collected from 53 participants recruited from Komfo Anokye Teaching Hospital and the Cape Coast Teaching Hospital, Ghana. Complementary DNA (cDNA) synthesis was performed, followed by quantitative polymerase chain reaction (qPCR) to amplify and quantify the expression levels of the target microRNAs. Expression levels of seven microRNAs-hsa-miR-146a, hsa-miR-29a, hsa-miR-29b, hsa-miR-34a, hsa-miR-233, hsa-miR-155, and hsa-miR-27a were compared among three groups: healthy controls (n = 27), patients with cervical cancer on therapy (n = 13), and those not on therapy (n = 13).

RESULTS: miR-155 and miR-27a showed statistically significant differential expression between cancer patients and healthy controls. In addition, miR-29b expression levels differed significantly between stage 4b and stage 4a of patient with cervical cancer undergoing treatment.

CONCLUSION: These findings suggest that circulating plasma miRNAs may serve as non-invasive biomarkers for the early detection of cervical cancer, monitoring disease progression, and evaluating treatment response.

PMID:40908329 | DOI:10.1007/s00432-025-06281-z

Aesthetic Plast Surg. 2025 Sep 4. doi: 10.1007/s00266-025-05191-2. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study is to compare the radiological measurements of patients who underwent rhinoplasty using a piezo device with those of patients who underwent rhinoplasty using a classical osteotome.

METHODS: A total of 60 patients were included in the study: 30 rhinoplasty patients who underwent piezosurgical osteotomy and 30 who underwent classical osteotomy. Preoperative and postoperative functional and aesthetic outcomes were compared using NOSE and ROE scores. Four anthropometric parameters were measured radiologically before and after surgery: nasofrontal angle (NFA), nasal bone length (NL), pyramidal angle (PA) and the closest distance between the nasolacrimal canal and the rhinoplasty fracture line (N-R). The pyramidal angle (PA) was measured separately at two levels: at the nasal root (PA-R) and at the tip of the nasal bone (PA-T).

RESULTS: The two groups were similar in terms of age, gender, and follow-up period (p > 0.05). The operative time was significantly longer in the Piezo group (p < 0.001). Preoperative and postoperative ROE values, as well as preoperative NOSE values, were comparable between the two groups (p > 0.05). However, postoperative NOSE values were statistically significantly lower in the Piezo group compared to the Osteotome group (p = 0.004). Surgery significantly affected both NOSE and ROE values in each group (p < 0.001). No statistically significant differences were found between the groups in terms of preoperative and postoperative NFA, PA-R, and PA-T values (p > 0.05). Preoperative NL values were also similar between the groups; however, postoperative NL values were significantly shorter in the Piezo group (p < 0.001). A statistically significant difference was observed in both right and left side N-R values between the groups (right: p = 0.025; left: p = 0.010), with the N-R distance being shorter in the Piezo group.

CONCLUSION: The long-term aesthetic outcomes of the piezosurgery and conventional osteotomy groups were similar; however, the piezosurgery group demonstrated better functional results. The safe margin for the nasolacrimal canal was narrower when osteotomy was performed using piezosurgery. This finding warrants caution regarding potential complications in the lacrimal system.

LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:40908317 | DOI:10.1007/s00266-025-05191-2